Leg pain relief after discography (LPRAD) in lumbar disc herniation: A retrospective analysis of an interesting phenomenon.

In clinical practice, we have observed that certain patients with lumbar disc herniation (LDH) experience leg pain relief after discography (LPRAD). This study aims to investigate and analyze the specific factors contributing to the LPRAD phenomenon. A retrospective analysis was conducted on patients with LDH who underwent discography. Patients were categorized into relief and non-relief groups based on postoperative visual analog scale (VAS) scores for leg pain. Comparisons of demographic, radiographic, and clinical outcomes were performed between the groups. The leg pain VAS was assessed at the 3-month follow-up. Sixty-nine cases were included in the final analysis. Of these, 22 patients who reported a leg pain VAS of less than 3 after discography were designated as the relief group, while the remaining 47 patients constituted the non-relief group. A proportion of patients (22.45%) experienced significant leg pain relief after discography. No significant differences were observed in baseline (P > .05). Before discography, the relief group exhibiting a greater disc height (P < .05). Additionally, the LDH level range of motion at the LDH level was significantly greater in the relief group (P < .05). The superior-inferior dimension of disc protrusions was also significantly smaller in the relief group (P < .05). We identified a phenomenon termed LPRAD, observed in 22.45% of our study cohort. This phenomenon may be linked to contrast-induced pressure changes in protruding anatomical regions and the dilution mechanisms of inflammatory mediators, and may help clinicians predict those who could benefit from discography.